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Drug overview for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
Generic name: NEOMYCIN SULF/BACITRACIN ZINC/POLYMYXIN B SULF/PRAMOXINE HCL
Drug class: Topical Local Anesthetics
Therapeutic class: Dermatological
Bacitracin is a polypeptide antibiotic. Neomycin is an aminoglycoside antibiotic.
No enhanced Uses information available for this drug.
Generic name: NEOMYCIN SULF/BACITRACIN ZINC/POLYMYXIN B SULF/PRAMOXINE HCL
Drug class: Topical Local Anesthetics
Therapeutic class: Dermatological
Bacitracin is a polypeptide antibiotic. Neomycin is an aminoglycoside antibiotic.
No enhanced Uses information available for this drug.
DRUG IMAGES
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The following indications for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl) have been approved by the FDA:
Indications:
Minor bacterial skin infections
Professional Synonyms:
Minor bacterial skin infection
Indications:
Minor bacterial skin infections
Professional Synonyms:
Minor bacterial skin infection
The following dosing information is available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
No enhanced Dosing information available for this drug.
No enhanced Administration information available for this drug.
No dosing information available.
No generic dosing information available.
The following drug interaction information is available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
There are 0 contraindications.
There are 1 severe interactions.
These drug interactions can produce serious consequences in most patients. Actions required for severe interactions include, but are not limited to, discontinuing one or both agents, adjusting dosage, altering administration scheduling, and providing additional patient monitoring. Review the full interaction monograph for more information.
| Drug Interaction | Drug Names |
|---|---|
| Long-acting Bupivacaine/Local Anesthetics SEVERITY LEVEL: 2-Severe Interaction: Action is required to reduce the risk of severe adverse interaction. MECHANISM OF ACTION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1) CLINICAL EFFECTS: Concurrent or use of local anesthetics with 96 hours of use of long-acting bupivacaine may result in neurologic and cardiovascular toxicity. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also result in methemoglobinemia.(1,2) Non-liposomal bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally.(1) PREDISPOSING FACTORS: Use of additional agents that are associated with methemoglobinemia may further increase the risk of methemoglobinemia.(1) Patients who are at increased risk of developing methemoglobinemia include those with glucose-6-phosphate dehydrogenase deficiency, congenital or idiopathic methemoglobinemia, cardiac or pulmonary compromise, infants under 6 months of age, and concurrent exposure to oxidizing agents or their metabolites are more susceptible to developing clinical manifestations of the condition. If local anesthetics must be used in these patients, close monitoring for symptoms and signs of methemoglobinemia is recommended.(1) PATIENT MANAGEMENT: Avoid the use of other local anesthetics within 96 hours following the administration of long-acting bupivacaine. In patients for whom use is required, monitor for neurologic and cardiovascular effects. Also monitor for methemoglobinemia with use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine.(1,2) Non-liposomal bupivacaine may be administered in the same syringe as bupivacaine liposomal or injected immediately before bupivacaine liposomal as long as the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1) DISCUSSION: Concurrent use of other local anesthetics or use of other local anesthetics within 96 hours following long-acting bupivacaine may result in additive neurologic and cardiovascular effects. Use of articaine, benzocaine, bupivacaine, lidocaine, mepivacaine, prilocaine, procaine, ropivacaine, and tetracaine may also increase the risk of methemoglobinemia.(1,2) Non-liposome bupivacaine may impact the pharmacokinetic and/or physicochemical properties of the liposomal formulation when administered in the same syringe or used simultaneously unless the ratio of mg of non-liposomal bupivacaine to mg of bupivacaine liposomal does not exceed 1:2.(1) Local anesthetics other than bupivacaine may trigger the immediate release of bupivacaine from the liposomal formulation when administered together locally. Lidocaine may be administered 20 minutes or more prior to bupivacaine. It is unknown if other local anesthetics may be used without compromising the release characteristic of bupivacaine liposomal.(1) |
BUPIVACAINE LIPOSOME, EXPAREL, XARACOLL, ZYNRELEF |
There are 0 moderate interactions.
The following contraindication information is available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
Drug contraindication overview.
No enhanced Contraindications information available for this drug.
No enhanced Contraindications information available for this drug.
There are 0 contraindications.
There are 2 severe contraindications.
Adequate patient monitoring is recommended for safer drug use.
| Severe List |
|---|
| Large open wound |
| Severe burns |
There are 2 moderate contraindications.
Clinically significant contraindication, where the condition can be managed or treated before the drug may be given safely.
| Moderate List |
|---|
| Large open wound |
| No disease contraindications |
The following adverse reaction information is available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
Adverse reaction overview.
No enhanced Common Adverse Effects information available for this drug.
No enhanced Common Adverse Effects information available for this drug.
There are 19 severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
|
Dermatitis due to topical drug Skin rash |
Dermatitis due to topical drug |
| Rare/Very Rare |
|---|
|
Acute respiratory failure Anaphylaxis Angioedema Bradycardia Bronchospastic pulmonary disease Cardiac arrhythmia CNS toxicity Cyanosis Eyelid edema Headache disorder Hypotension Methemoglobinemia Ototoxicity Respiratory depression Seizure disorder Unconsciousness |
There are 22 less severe adverse reactions.
| More Frequent | Less Frequent |
|---|---|
| None. |
Blanching of skin Edema Erythema Pruritus of skin Skin rash Stinging of skin Urticaria |
| Rare/Very Rare |
|---|
|
Acute cognitive impairment Apprehension Blurred vision Dizziness Drowsy Euphoria Fungal infection of skin Muscle fasciculation Nervousness Sensation of cold Sensation of warmth Skin rash Tinnitus Tremor Vomiting |
The following precautions are available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
No enhanced Pediatric Use information available for this drug.
Contraindicated
Severe Precaution
Management or Monitoring Precaution
Contraindicated
| None |
Severe Precaution
| None |
Management or Monitoring Precaution
| None |
Bacitracin and bacitracin zinc should be used during pregnancy only if potential benefits justify potential risks to the fetus. Some manufacturers state that patients who are pregnant should consult a clinician before using topical preparations containing bacitracin or bacitracin zinc. The topical preparation containing bacitracin zinc, neomycin sulfate, polymyxin B sulfate, and hydrocortisone should be used during pregnancy only if potential benefits justify potential risks to the fetus.
Corticosteroids have been teratogenic in mice and rabbits when applied topically. Aminoglycosides may cause fetal harm following systemic absorption in pregnant women. The drugs cross the placenta and total, irreversible, bilateral, congenital deafness has been reported in some children whose mothers received parenteral streptomycin during pregnancy.
Fixed-combination topical preparations containing neomycin sulfate and a corticosteroid should be used during pregnancy only if potential benefits justify potential risks to the fetus. Corticosteroids have been teratogenic in animals (mice, rabbits) when applied topically. If the irrigation solution containing neomycin sulfate and polymyxin B sulfate is used for bladder irrigation during pregnancy, the patient should be informed of the potential hazard to the fetus.
Corticosteroids have been teratogenic in mice and rabbits when applied topically. Aminoglycosides may cause fetal harm following systemic absorption in pregnant women. The drugs cross the placenta and total, irreversible, bilateral, congenital deafness has been reported in some children whose mothers received parenteral streptomycin during pregnancy.
Fixed-combination topical preparations containing neomycin sulfate and a corticosteroid should be used during pregnancy only if potential benefits justify potential risks to the fetus. Corticosteroids have been teratogenic in animals (mice, rabbits) when applied topically. If the irrigation solution containing neomycin sulfate and polymyxin B sulfate is used for bladder irrigation during pregnancy, the patient should be informed of the potential hazard to the fetus.
It is not known whether topical bacitracin is distributed into milk. Some experts consider topical bacitracin compatible with nursing. Some manufacturers state that patients who are breast-feeding should consult a clinician before using topical preparations containing bacitracin or bacitracin zinc.
The topical preparation containing bacitracin zinc, neomycin sulfate, polymyxin B sulfate, and hydrocortisone should be used with caution in nursing women. Hydrocortisone is distributed into human milk following oral administration, and systemic absorption may occur when hydrocortisone is applied topically. Clinically unimportant amounts of neomycin may distribute into breast milk following systemic absorption of the drug.
Fixed-combination topical preparations containing neomycin sulfate and a corticosteroid should be used with caution in nursing women. Corticosteroids administered systemically (e.g., orally) are distributed into human milk, and systemic absorption may occur when the drugs are applied topically.
The topical preparation containing bacitracin zinc, neomycin sulfate, polymyxin B sulfate, and hydrocortisone should be used with caution in nursing women. Hydrocortisone is distributed into human milk following oral administration, and systemic absorption may occur when hydrocortisone is applied topically. Clinically unimportant amounts of neomycin may distribute into breast milk following systemic absorption of the drug.
Fixed-combination topical preparations containing neomycin sulfate and a corticosteroid should be used with caution in nursing women. Corticosteroids administered systemically (e.g., orally) are distributed into human milk, and systemic absorption may occur when the drugs are applied topically.
No enhanced Geriatric Use information available for this drug.
The following prioritized warning is available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl):
No warning message for this drug.
No warning message for this drug.
The following icd codes are available for FIRST AID ANTIBIOTIC-PAIN RLF (neomycin sulf/bacitracin zinc/polymyxin b sulf/pramoxine hcl)'s list of indications:
| Minor bacterial skin infections | |
| L08.89 | Other specified local infections of the skin and subcutaneous tissue |
| L08.9 | Local infection of the skin and subcutaneous tissue, unspecified |
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